CCGs push for NHS England collaboration to decommission underperforming GPs

CCGs should form joint committees with NHS England local area teams and the rules changed so they can decommission GPs not up to standard, according to NHS Clinical Commissioners.

Dr Kell: 'The development of primary care is most effective when there is close collaboration.'
Dr Kell: 'The development of primary care is most effective when there is close collaboration.'

In a briefing document published today entitled Commissioning primary care Transforming healthcare in the community, NHS Clinical Commissioners says in November the DH consulted on a legislative reform order that will allow CCGs to form joint committees with NHS England to exercise a CCG’s functions. It is expected to come into force this October.

The report adds: ‘If this was taken to the next stage – allowing a joint committee to exercise an area team’s functions – it would greatly assist NHS England and CCGs in their goal of developing primary care.’

The briefing follows a meeting between representatives of NHS England, the BMA, Association of Medical Royal Colleges, RCN, RCGP, Family Doctor Association and NHS Confederation.

The 12-page document adds that local area teams are struggling with workload to the detriment of comprehensive primary care strategies for areas.

On decommissioning it says: ‘The rules need to be changed to enable commissioners to decommission GPs who are not up to standard. CCGs need to be robust in identifying individuals and practices who are failing with NHS England supporting that action with the appropriate contracting levers.’

On GP income it continues: ‘Investing in primary care does not mean more money going into individual GPs’ income; it means investing in new and better services. To win political and public support for moving funds from hospitals to primary and community services, and to overcome concerns about conflicts of interest if CCGs play a bigger role in primary care commissioning, GP practices need to be far more transparent and accountable about how money is used.’

On PMS it says: ‘NHS England has been concerned that, where services have been funded through PMS agreements, it has often been unclear how the money has been spent. This cannot continue.’

On publishing GP income it continues: ‘ The government has been promoting more transparency in primary care. The new GP contract promotes openness through GPs having to publish net NHS earnings relating to the contract (probably an average of drawings and salaries across each practice rather than individual pay) from April 2015. There has been considerable resistance to this move, but GPs need to accept that in the current climate of austerity and growing transparency of public spending, the price of moving money from hospitals to primary care will include greater openness and public accountability.’

Dr Steve Kell, co-chairman of the NHS Clinical Commissioners Leadership Group said: ‘The development of primary care is most effective when there is close collaboration between CCGs and local NHS England areas teams.

‘There are a range of well tested and effective mechanisms that can easily be put in place to ensure CCG decision making processes remain open. Taking these steps would free up all parties, allowing them to remain accountable and still push local service improvements forward.’

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